From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada.
Radiology. 2017 Oct;285(1):231-241. doi: 10.1148/radiol.2017162114. Epub 2017 May 22.
Purpose To estimate reference ranges for blood flow volume (BFV) in major splanchnic, thoracoabdominal, and neck vessels by using phase-contrast magnetic resonance (MR) imaging in children and young adults in fasting and postprandial states. Materials and Methods In this institutional research ethics board-approved prospective study, healthy volunteers underwent phase-contrast MR imaging in a fasting state and again after a standardized meal. BFV values were reported as medians and ranges, and postmeal to premeal BFV ratios were calculated. BFVs in volunteers divided into two groups according to age (≤18 years old and >18 years old) were compared by using the Mann-Whitney test adjusted for multiple comparisons. Linear regression for internal validation of BFV and Pearson correlation and Bland-Altman analysis for interobserver agreement were used. Results Reference ranges for BFVs were estimated in 39 volunteers (23 male and 16 female; mean age, 21.2 years ± 8.5; range, 9-40 years) and were indexed according to body surface area, with internal validation (R = 0.84-0.92) and excellent interobserver agreement (R = 0.9928). There was an almost 30% increase in total abdominal BFV (P < .0001) in response to a meal, which was the result of a threefold increase in superior mesenteric artery BFV (P < .0001). BFV after the meal remained unaffected in the celiac artery and cerebral circulation. Significantly higher normalized BFVs in the cerebral circulation were measured in children with both preprandial (P = .039) and postprandial (P = .008) status than those in adults. Conclusion Reference ranges for BFVs and changes in BFVs in response to a meal in major splanchnic, thoracoabdominal, and neck vessels were estimated by using phase-contrast MR imaging in healthy volunteers to allow hemodynamic assessment of children and young adults with various diseases. RSNA, 2017 Online supplemental material is available for this article.
目的 利用相位对比磁共振成像（MR 成像）在空腹和餐后状态下估计儿童和年轻成人主要内脏、胸腹和颈部血管的血流量（BFV）参考范围。
材料与方法 在这项机构研究伦理委员会批准的前瞻性研究中，健康志愿者在空腹状态下和标准餐后进行相位对比 MR 成像。BFV 值以中位数和范围报告，并计算餐后与餐前 BFV 比值。根据年龄（≤18 岁和>18 岁）将志愿者分为两组，采用 Mann-Whitney 检验对多组比较进行调整，比较两组 BFV 值。使用内部 BFV 验证的线性回归和观察者间一致性的 Pearson 相关和 Bland-Altman 分析。
结果 在 39 名志愿者（23 名男性和 16 名女性；平均年龄 21.2 岁±8.5 岁；年龄范围 9-40 岁）中估计了 BFV 的参考范围，并根据体表面积进行了索引，内部验证（R = 0.84-0.92）和观察者间一致性良好（R = 0.9928）。餐后总腹部 BFV 增加近 30%（P<0.0001），这是肠系膜上动脉 BFV 增加三倍的结果（P<0.0001）。餐后腹腔动脉和脑循环的 BFV 不受影响。儿童的餐后脑循环归一化 BFV 明显高于成人（餐前状态：P=0.039；餐后状态：P=0.008）。
结论 在健康志愿者中，利用相位对比 MR 成像估计了主要内脏、胸腹和颈部血管 BFV 参考范围及其对餐食的反应变化，可用于评估各种疾病的儿童和年轻成人的血液动力学情况。
放射学学会，2017 年
在线补充材料可在本文中获取。
